Active NPI
Tawana Campbell, COTA
- Occupational Therapy Assistant
- Palm Bay, FL
National Provider Identifier
1184087751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 10729
- Practice address
- 926 Black Coral Ave NW
Palm Bay, FL 32907-9493 - Phone
- (321) 750-6809
- NPI assigned
- Mar 31, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 10729 | FL | Primary |
| Occupational Therapist | 225X00000X | OC60632347 | WA |
Addresses
Primary practice location
926 Black Coral Ave NW
Palm Bay, FL 32907-9493
Mailing address
926 Black Coral Ave NW
Palm Bay, FL 32907-9493
Phone (321) 750-6809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10729 | FL | MD | Occupational Therapy Assistant |
| OC60632347 | WA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459382400000",
"number": "1184087751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "926 BLACK CORAL AVE NW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329079493",
"telephone_number": "321-750-6809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "926 BLACK CORAL AVE NW",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329079493",
"telephone_number": "321-750-6809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPBELL",
"first_name": "TAWANA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-31",
"last_updated": "2016-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "10729",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OC60632347",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.